Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study.

BACKGROUND: Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. METHODS: This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. RESULTS: A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017). CONCLUSIONS: This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04352634.

Internalizing problems can differ in boys and girls since early childhood: Findings from the Child Behavioral Checklist 1.5-5 (CBCL 1.5-5).

BACKGROUND: Globally, internalizing problems disproportionately affect females in adolescence and adulthood, with limited research at earlier ages due to a focus on disruptive behaviors. Our study addresses this gap by exploring the structure of internalizing problems and gender differences in Brazilian preschoolers. METHODS: We analyzed data from the Child Behavioral Checklist 1.5-5 in the Preschool Mental Health Study, involving 1,292 children aged 4 to 5 in Embu das Artes, São Paulo, Brazil. Confirmatory factor analysis and mean comparisons explored internalizing problems and gender variations. RESULTS: A two-factor model best fit both internalizing and externalizing problems.The hierarchical model with four factors (Emotionally Reactive, Anxiety/Depression, Somatic Complaints, and Withdrawn) best fit internalizing problems, achieving partial invariance between boys and girls. Boys scored higher in Withdrawn Syndrome, while girls scored higher in Somatic Complaints Syndrome. CONCLUSIONS: Preschoolers' internalizing problems warrant attention beyond their link to externalizing problems. While the overall construct is similar in boys and girls, divergent syndrome scores indicate potential distinct risk patterns requiring further exploration.

Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic.

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.

Exhausting care: On the collateral realities of caring in the early days of the Covid-19 pandemic.

We explore care as a site of multiplicity and tension. Working with the qualitative interview accounts of nineteen health care workers in Colombia, we trace a narrative of 'exhausting care' in the early days of the Covid-19 pandemic. Accounts relate exhausting care to working without break in response to extraordinary demand, heightened contagion concern, the pressures of caring in the face of anticipated death, and efforts to carry on caring in the face of constraint. We bring together the work of John Law (2010, 2011) on 'collateral realities' with Lauren Berlant's (2011) thesis of 'cruel optimism' to explore care as a site of practice in which the promise of the good can also become materialised as harm, given structural conditions. Through the reflexive narrative of 'carrying on' in the face of being 'worn down' by care, a narrative which runs through health care worker accounts, we draw attention to the collateral realities of exhausting care as personal and political, at once a practice of endurance and extraction. We argue that the exhausting care that relates to the extraordinariness of the Covid-19 pandemic also resides in the ordinariness, and slower violence, of the everyday. The cruel optimism of care is a relation in which the labour of care reproduces a harmful situation.

OnTrack Chile for people with early psychosis: a study protocol for a Hybrid Type 1 trial.

BACKGROUND: Substantial data from high-income countries support early interventions in the form of evidence-based Coordinated Specialty Care (CSC) for people experiencing First Episode Psychosis (FEP) to ameliorate symptoms and minimize disability. Chile is unique among Latin American countries in providing universal access to FEP services through a national FEP policy that mandates the identification of FEP individuals in primary care and guarantees delivery of community-based FEP treatments within a public health care system. Nonetheless, previous research has documented that FEP services currently provided at mental health clinics do not provide evidence-based approaches. This proposal aims to address this shortfall by first adapting OnTrackNY (OTNY), a CSC program currently being implemented across the USA, into OnTrackChile (OTCH), and then examine its effectiveness and implementation in Chile. METHODS: The Dynamic Adaptation Process will be used first to inform the adaptation and implementation of OTCH to the Chilean context. Then, a Hybrid Type 1 trial design will test its effectiveness and cost and evaluate its implementation using a cluster-randomized controlled trial (RCT) (N = 300 from 21 outpatient clinics). The OTCH program will be offered in half of these outpatient clinics to individuals ages 15-35. Usual care services will continue to be offered at the other clinics. Given the current COVID-19 pandemic, most research and intervention procedures will be conducted remotely. The study will engage participants over the course of 2 years, with assessments administered at enrollment, 12 months, and 24 months. Primary outcomes include implementation (fidelity, acceptability, and uptake) and service outcomes (person-centeredness, adherence, and retention). Secondary outcomes comprise participant-level outcomes such as symptoms, functioning, and recovery orientation. Over the course of the study, interviews and focus groups with stakeholders will be conducted to better understand the implementation of OTCH. DISCUSSION: Findings from this study will help determine the feasibility, effectiveness, and cost for delivering CSC services in Chile. Lessons learned about facilitators and barriers related to the implementation of the model could help inform the approach needed for these services to be further expanded throughout Latin America. TRIAL REGISTRATION: www. CLINICALTRIALS: gov NCT04247711 . Registered 30 January 2020. TRIAL STATUS: The OTCH trial is currently recruiting participants. Recruitment started on March 1, 2021, and is expected to be completed by December 1, 2022. This is the first version of this protocol (5/12/2021).

A Recovery-Oriented Intervention for People With Psychosis: A Pilot Randomized Controlled Trial.

OBJECTIVE: This pilot randomized controlled trial evaluated the effectiveness of critical time intervention-task shifting (CTI-TS) for people with psychosis in Santiago, Chile, and Rio de Janeiro. CTI-TS is a 9-month intervention involving peer support workers and is designed to maintain treatment effects up to 18 months. METHODS: A total of 110 people with psychosis were recruited when they enrolled in community mental health clinics (Santiago, N=60; Rio de Janeiro, N=50). Participants within each city were randomly assigned to either CTI-TS or usual care for 9 months. Primary outcomes were quality of life, measured with the World Health Organization Quality of Life Assessment-Brief Version (WHOQOL-BREF), and unmet needs, measured with the Camberwell Assessment of Need (CAN), at 18-month follow-up. Results were analyzed according to intention-to-treat guidelines. Generalized estimating equations, with observations clustered within cities, and multiple imputation for missing data were used. RESULTS: At 18 months, both groups showed improved primary outcomes. In both unadjusted and fully adjusted analyses, no significant differences between CTI-TS and usual care (WHOQOL-BREF question on quality of life and CAN mean number of unmet needs) were found. CONCLUSIONS: Three factors might explain the lack of difference between CTI-TS and usual care: first-contact enrollment precluded rapport prior to randomization, a minority of patients were uncomfortable with peers being on the treatment team, and primary outcome measures may not have been sensitive enough to capture the effects of a recovery-oriented intervention. The results have implications for the design of transitional services for people with psychosis, especially in Latin America.

Household composition after resettlement and emotional health in adolescent migrants.

Background: Migration during adolescence constitutes an important stressor that particularly impacts unaccompanied minors (UAM). Adolescent UAM in the United States (U.S.) are relatively understudied, especially regarding their resilience and emotional well-being after resettlement. Small school-based studies have documented the mental health status of UAM who resettled reuniting with their parents. However, many do not resettle with parents and less is known about the degree to which post-resettlement household composition impacts resilience and emotional well-being. Methods: Our goal was to examine how migration characteristics, supports, resilience, and emotional well-being vary by UAM resettlement household composition (reunification with parents, reunification with a non-parental family member, or living in a household not containing any family members). Using a mixed-methods (quantitative-qualitative) cross-sectional approach, we assessed 46 Latin American adolescent UAM to the U.S. who resettled into these three household types. Results: Youth experienced support differently by household type, influencing their strategies for adapting and coping post-resettlement, impacting their resilience (Kruskal Wallis-H 4.8; p<0.09) and emotional well-being (Kruskal Wallis 5.3; p<0.07). Youth living in households without relatives (n = 9) had lower resilience (Fisher's exact test p<0.002) and positive affect (Fisher's exact test p<0.003) and needed to expend greater efforts to mobilize social supports than youth living with parents (n = 22) or with non-parental family members (n = 15). Conclusion: The needs and coping abilities of UAM migrants vary with the composition of their immediate receiving environment, their post-resettlement household. Understanding differences associated with these household characteristics can guide interventions to maximize emotional health and resilience.

Delta variant of SARS-CoV-2: characteristics and implications for public health in Colombia / Variante delta del SARS-CoV-2: características e implicaciones para la salud pública en Colombia

Abstract The SARS-CoV-2 Delta variant has become one of the greatest public health challenges worldwide since, after being first identified in India in December 2020, it has spread rapidly, affecting mainly countries with low vaccination rates and those that have relaxed the public health and social measures implemented to control the COVID-19 pandemic. The Delta variant has a higher replication capacity and is associated with viral loads up to 1 260 times higher than those of infections caused by the original strain, which may be associated with an increased likelihood of hospitalization, ICU admission, need for oxygen therapy, pneumonia, or even death. Fully vaccinated individuals have almost similar protection against both Delta and Alpha variants. Given the impact of Delta in countries where it is the dominant variant, it is necessary for all countries to develop systematic action plans focused on implementing strict public health and social measures in the context of the COVID-19 pandemic and on increasing vaccination coverage. Bearing this in mind, the objective of this reflection paper is to describe the main characteristics of the Delta variant, its impact on the dynamics of the pandemic in some of the countries where it has been detected, the effectiveness of vaccines against this variant, and its implications for public health in Colombia.

Resumen La variante delta del SARS-CoV-2 se ha convertido en uno de los mayores desafíos en salud pública a nivel mundial, ya que, luego de su identificación en la India en diciembre de 2020, se ha extendido de manera rápida, afectando principalmente a los países con bajas tasas de vacunación, y aquellos que han flexibilizado las medidas de salud pública establecidas para controlar la pandemia por COVID-19. La variante delta tiene una mayor capacidad de replicación y se asocia con cargas virales hasta 1 260 veces más altas en comparación con las de infecciones causadas por la cepa original, lo cual puede estar asociado a mayores probabilidades de hospitalización, ingreso a UCI, necesidad de oxigenoterapia, neumonía, o incluso muerte. Las personas con vacunación completa tienen una protección casi similar contra las variantes delta y alfa. Dado el impacto de delta en los países afectados en los que es la variante dominante, es necesario que todos los países desarrollen planes de acción sistemáticos enfocados en implementar estrictas medidas de salud pública y sociales en el contexto de la pandemia por COVID-19, y aumentar la cobertura de vacunación. Teniendo en cuenta lo anterior, el objetivo de esta reflexión es describir las principales características de la variante delta, su impacto en la dinámica de la pandemia en algunos de los países en que ha sido detectada, la efectividad de las vacunas contra esta variante, y sus implicaciones para la salud pública en Colombia.

The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study.

BACKGROUND: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. METHODS: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country's income level. RESULTS: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. CONCLUSIONS: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings.

Critical reflections on the Municipal Epidemiological Resilience Index used for public policy decision-making regarding the control of the COVID-19 pandemic in Colombia

On June 2, 2021, the Colombian Ministry of Health and Social Protection, through Resolution No. 777, laid down the requirements to resume all restricted economic and social activities. Similarly, said Resolution established the Municipal Epidemiological Resilience Index (IREM by its acronym in Spanish) as a tool to support decision-making regarding this economic reactivation amid the third epidemic peak of COVID-19 in the country. The purpose of this article is to perform a critical analysis of the technical aspects of the IREM and to explore the feasibility of its implementation as a support for the resumption of economic and social activities as proposed in the Resolution. The present critical analysis emphasizes on the lack of a clear definition of epidemiological resilience that is consistent with the scientific literature. Furthermore, the face and content validity of the index, as well as the construct validity of the index and of its dimensions, are called into question and, therefore, the feasibility of using it to determine said resumption.

El 2 de junio de 2021, el Ministerio de Salud y Protección Social de Colombia expidió la Resolución 777, mediante la cual se determinan las condiciones para el reinicio de todas las actividades económicas y sociales restringidas. Asimismo, en esta resolución se define el Índice de resiliencia epidemiológica municipal (IREM) como la herramienta para apoyar la toma de decisiones relacionadas con esta reactivación económica en medio del tercer pico epidémico de la COVID-19 en el país. El objetivo de este artículo es hacer un análisis crítico de los aspectos técnicos del IREM y explorar la conveniencia de su implementación como soporte del reinicio de las actividades económicas y sociales propuesto en la resolución. Dentro de este análisis crítico se destaca la falta de una clara definición de resiliencia epidemiológica que se ajuste a la literatura científica. Además, se cuestiona tanto la validez de apariencia, contenido y constructo del índice global, como la validez del constructo de sus dimensiones y, por tanto, la pertinencia de usarlo como herramienta para definir dicho reinicio.

Disengagement From Early Intervention Services for Psychosis: A Systematic Review.

OBJECTIVE: Therapeutic benefits associated with early services for psychosis are influenced by the degree to which participants engage in treatment. The main objective of this review was to analyze rates of disengagement in early psychosis services and identify predictors of disengagement in these settings. METHODS: A systematic search for studies published in the 1966-2019 period was conducted in PubMed, Google Scholar, EBSCO, Ovid, and Embase. The Observational Cohort and Cross-Sectional Studies scale was used to assess the methodological quality of reports identified in this search. A revised version of the behavioral model of health service use was employed to evaluate and understand predictors of disengagement (categorized as predisposing, enabling, and need factors) identified in the studies with the highest quality. RESULTS: Twenty studies met the inclusion criteria. Disengagement rates (12% to 53%) and definitions of disengagement varied widely across these studies. Most did not find a compelling association between predisposing factors (e.g., age) and disengagement. Enabling factors, such as lack of family support and living alone, were consistently found to be related to increased disengagement across studies. Finally, need factors, such as lower medication adherence and higher drug misuse, were associated with higher risk for disengagement. CONCLUSIONS: Enabling and need factors seemed to be the most predictive of disengagement from early psychosis services. Substantial between-study variation in identified predictors of disengagement may be addressed by developing and applying a consensus definition of disengagement in future research.

Validation of Spanish version of the human papilloma virus impact profile (HIP).

Objective: To examine the construct validity and reliability of the Spanish version of the HPV Impact Profile scale (HIP) among women in Medellin, Colombia.Methods: We conducted a nested analysis of data from the pragmatic randomized controlled trial "Evaluation of Strategies for Optimal Clinical Management of Women with Atypical Squamous Cells of Undetermined Significance" (ASCUS-COL; NCT02067468). Women with Atypical Squamous Cells of Undetermined Significance (ASCUS) were randomly assigned to one of three triage strategies (Pap smear, colposcopy, HPV). Participants completed a questionnaire with sociodemographic information and the HIP scale translated into Spanish at baseline, two weeks after receiving triage test results, and one year after the second questionnaire. We conducted exploratory and confirmatory factorial analysis, and then assessed test reliability using Cronbach's alpha. Subsequently, we conducted multigroup confirmatory factor analysis to assess differences according to women´s age, and configurational invariance of the factor structure over the three time measures.Results: The sample consisted of 675 women, with a mean age of 40 years. The exploratory and confirmatory factor analysis for the HIP showed a seven-factor structure with appropriate adjustment indicators ([Formula: see text]= 1466.783, p < .0001). Only two items (1 and 10) had low factor loads and were removed from the confirmatory analysis. Multigroup analysis according to women's age showed acceptable goodness of fit (RMSEA = 0.037, CFI/TLI:0.998/0.998). The factor structure was similar among the tree measures and the model preserved acceptable goodness of fit (RMSEA = 0.079, CFI:0.86). The Cronbach's alpha for the total score was 0.91, with the lowest score for sexual impact (0.49) and the highest score for worries and concerns (0.90).Conclusions: The Spanish version of the HIP had adequate reliability and construct validity, and its use could be considered in clinic and research settings.

Programa de prevención temprana de conductas de riesgo para la salud en preescolares y escolares. Medellín, 2009-2012: una posibilidad para la prevención temprana de las conductas de riesgo en Latinoamérica / Program for the early prevention of health risk behaviors in preschool and school-aged children. Medellín, 2009-2012: a possibility of early prevention of risk behaviors in Latin America

OBJETIVO: Evaluar el impacto del programa "¡PILAS! Mejores adultos, mejores niños" diseñado por PREVIVA (Facultad Nacional de Salud Pública, Universidad de Antioquia), con el fin de prevenir conductas de riesgo en niños y niñas de 4 a 11 años de preescolares y escuelas primarias. En el presente artículo se presentaron algunos resultados de la línea de base y la descripción y implementación del programa. MÉTODOS: Se escogieron aleatoriamente 32 escuelas públicas de la zona urbana de Medellín. Se asignaron de manera aleatoria 16 a la intervención y 16 al Grupo Control. Se siguieron 862 niños en el Grupo Intervenido y 874 en el Grupo Control, escogidos aleatoriamente. RESULTADOS: Fue implementado y se está llevando a cabo la evaluación del programa de prevención temprana de la agresión y las conductas de riesgo para la salud en Medellín "¡PILAS! Mejores adultos, mejores niños". La prevalencia de agresión encubierta en el último año fue del 62%, agresión abierta del 34%, y la conducta oposicionista del 2%, según el reporte del cuidador. Los niños reportaron menor prevalencia que los cuidadores para la agresión encubierta y abierta (los 45 y 20%) y superiores para el trastorno oposicionista (el 23%). Se encontró asociación entre diversas formas de castigo y maltrato y las conductas agresivas y oposicionistas de los niños. CONCLUSIONES: Existen altas prevalencias de las conductas agresivas en los niños y de castigo mediante agresión y maltrato contra el niños, y estas formas de agresión se encuentran asociadas con las conductas agresivas de los niños, por los cuales se hace necesario continuar la evaluación de la intervención y extenderla a otras instituciones educativas, introducidos los cambios que sean aconsejables de acuerdo con los resultados de la evaluación.

OBJECTIVE: To evaluate the impact of the "¡PILAS! Mejores adultos, mejores niños" program, which was designed by PREVIVA (Universidad de Antioquia's School of Public Health), in order to prevent risk behaviors in preschool and primary schoolchildren, aged 4 to 11 years-old. This article presented baseline results and the description and implementation of such program. METHODS: Thirty-two urban public schools in Medellin were chosen at random, and 16 of them were randomly assigned to the intervention, with the remaining 16 placed in the Control Group. There were 862 children randomly chosen in the Intervention Group and 874 ones in the Control Group. RESULTS: The "¡PILAS! Mejores adultos, mejores niños" program was evaluated by examining early prevention of aggression and risk behaviors. According to the children's guardians, in the past year, there was a 62% prevalence of disguised aggression, a 34% prevalence of open aggression, and a 2% prevalence of oppositional behavior. The children reported lower prevalence of disguised and open aggression (45 and 20%, respectively) and a higher one of oppositional behavior (23%). There was an association between various forms of punishment and mistreatment, and aggressive and oppositional behaviors in children. CONCLUSIONS: There is a high prevalence of aggressive behavior in schoolchildren and a high one of aggressive means of punishment and mistreatment of children. These aggressive actions toward children are associated with aggressive behavior in kids further necessitating the continued evaluation of the "¡PILAS!" intervention and its expansion to additional schools. Results of the evaluation should be incorporated to improve the program.

[Paragonimus sp. in crabs and awareness of the educational community to aquatic ecosystems in La Miel and La Clara, Caldas, Antioquia]. / Paragonimus sp. en cangrejos y sensibilización de la comunidad educativa hacia los ecosistemas acuáticos de La Miel y La Clara, Caldas, Antioquia.

INTRODUCTION: Previous research has demonstrated the presence of Paragonimus spp. in crabs of three municipalities located in the Medellín river basin. To design a plan for the control and prevention of paragonimosis, parasite presence must be demonstrated in the upper area of the river, and an awareness campaign of its risks must involve the participation of the educational community in focusing attention on the local aquatic resources. OBJECTIVE: The presence of Paragonimus spp. metarcercariae was established in freshwater crabs from La Miel and La Clara streams, and an awareness campaign created public awareness to management of the aquatic ecosystems for risk reduction. MATERIALS AND METHODS: Nine crabs were collected from streams of La Miel and La Clara villages in 2007 and 2008. The crabs were indentified, sacrificed in the laboratory and examined for presence of Paragonimus spp. metacercariae. Five workshops were conducted with students of educational institutions of the two villages to improve the student perception of paragonimosis risks associated with the local streams. RESULTS: The crabs were identified as Hypolobocera bouvieri. One crab was found with Paragonimus spp. in La Miel. A mollusk, Aroapyrgus colombiensis, another host of the parasite was found in La Clara. That aquatic ecosystems are a great attraction for the local was well established. CONCLUSIONS: Foci of Paragonimus spp. flatworms are present in the upper area of Medellín river which includes Caldas. However, local school children were uninformed about the risk of paragonimosis associated with the local aquatic ecosystem. Therefore this province must be included in programs for prevention and control of paragonimosis. The prevalence of this disease recommends educational programs that promote awareness of local aquatic ecosystems and their parasitic inhabitants.

Paragonimus sp. en cangrejos y sensibilización de la comunidad educativa hacia los ecosistemas acuáticos de La Miel y La Clara, Caldas, Antioquia / Paragonimus sp. in crabs and awareness of the educational community to aquatic ecosystems in La Miel and La Clara, Caldas, Antioquia

Introducción. Estudios previos demostraron la presencia de Paragonimus sp. en cangrejos de tres municipios en la cuenca del río Medellín. Para diseñar un plan para el control y la prevención de la paragonimosis, es necesario determinar la presencia del parásito en la parte alta del río, con la participación de la comunidad educativa, para dirigir su atención hacia el recurso hídrico. Objetivo. Establecer la presencia de metacercarias de Paragonimus sp. en cangrejos de las quebradas La Miel y La Clara, y sensibilizar a la comunidad educativa hacia el manejo adecuado de sus ecosistemas acuáticos. Materiales y métodos. En 2007 y 2008 se recolectaron cangrejos de quebradas de las veredas La Miel y La Clara. En el laboratorio se relajaron y sacrificaron para buscar metacercarias de Paragonimus sp. y determinar la especie. Con estudiantes de instituciones educativas de ambas veredas, se llevaron a cabo cinco talleres lúdicos, para mejorar la percepción de su relación con sus quebradas. Resultados. Se capturaron nueve cangrejos Hypolobocera bouvieri. En La Miel se halló uno con Paragonimus sp. En La Clara se encontró, además, Aroapyrgus colombiensis, molusco huésped del parásito. Con los estudiantes se estableció que los ecosistemas acuáticos ejercen una gran atracción sobre ellos; sin embargo, desconocen los riesgos y no sostienen una relación responsable. Conclusiones. Se señala la presencia de focos de Paragonimus sp. en la parte alta del río Medellín; por lo tanto, el municipio de Caldas debe incluirse en los programas de prevención y control. La población estudiantil requiere nuevos programas educativos para mejorar la interacción con los ecosistemas acuáticos y disminuir el deterioro de su salud.

Introduction. Previous research has demonstrated the presence of Paragonimus spp. in crabs of three municipalities located in the Medellín river basin. To design a plan for the control and prevention of paragonimosis, parasite presence must be demonstrated in the upper area of the river, and an awareness campaign of its risks must involve the participation of the educational community in focusing attention on the local aquatic resources. Objective. The presence of Paragonimus spp. metarcercariae was established in freshwater crabs from La Miel and La Clara streams, and an awareness campaign created public awareness to management of the aquatic ecosystems for risk reduction. Materials and methods. Nine crabs were collected from streams of La Miel and La Clara villages in 2007 and 2008. The crabs were indentified, sacrificed in the laboratory and examined for presence of Paragonimus spp. metacercariae. Five workshops were conducted with students of educational institutions of the two villages to improve the student perception of paragonimosis risks associated with the local streams. Results. The crabs were identified as Hypolobocera bouvieri. One crab was found with Paragonimus spp. in La Miel. A mollusk, Aroapyrgus colombiensis, another host of the parasite was found in La Clara. That aquatic ecosystems are a great attraction for the local was well established. Conclusions. Foci of Paragonimus spp. flatworms are present in the upper area of Medellín river which includes Caldas. However, local school children were uninformed about the risk of paragonimosis associated with the local aquatic ecosystem. Therefore this province must be included in programs for prevention and control of paragonimosis. The prevalence of this disease recommends educational programs that promote awareness of local aquatic ecosystems and their parasitic inhabitants.

Competencias laborales del psicólogo javeriano en diferentes áreas aplicativas: clínica, educativa, social y organizacional / Laboral competences of the javeriana university psychologists in different applied areas: clinical, educational, social and organizational

Esta investigación busca describir tanto las competencias laborales genéricas y específicas del psicólogo javeriano de acuerdo con el área aplicativa: clínica, educativa, organizacional y social, como las competencias laborales requeridas por los empleadores de psicólogos, mediante la aplicación de la Encuesta de Competencias del Psicólogo Javeriano, tomada de Herrera, Restrepo y Uribe (2006), y una entrevista semiestructurada aplicada solo a psicólogos javerianos. Se conformó una muestra de 22 psicólogos egresados de la Pontificia Universidad Javeriana Cali y 13 informantes empleadores de psicólogos. Se realizó un análisis descriptivo por medio del paquete estadístico SPSS, para describir los ítems de la encuesta realizada. A partir de los resultados y el análisis realizado, se encontraron diferencias entre las valoraciones dadas por empleadores y psicólogos javerianos respecto a las competencias en cada área aplicativa, y se logró ratificar la especificidad de las competencias, de acuerdo al área. De igual forma, se puede afirmar que existen competencias genéricas para los profesionales en psicología, de las cuales se hallaron similitudes respecto a las percepciones de empleadores y psicólogos egresados.

This research aims to describe general and specific laboral competencies of the Javeriana University psychologists according to his performance area whether clinical, educational, organizational or social; as well as to describe the laboral competencies required by the psychologist employers through a survey named: Encuesta de Competencias del Psicólogo Javeriano (Herrera, Restrepo y Uribe, 2006), and an interview applied only to Javeriana University psychologists. The sample was formed by 22 psychologists graduated from the Javeriana University and 13 psychologists' employers. A descriptive analysis was done with the software SPSS in order to describe the survey items results. Based on the results and the analysis, it was found several differences between the employers and psychologists valuations of the competencies in each performance areas which show the specific nature of competencies according to the specific area. Also, it is possible to say that there are generic competences for psychologists from which were found similarities concerning the employers and graduated psychologists.